One of the more esoteric but much beloved tools in the paleo dieter’s tool-kit is intermittent fasting.

What is intermittent fasting? I.F. is the practice of maintaining overall caloric intake while consuming those calories in fewer meals or in reduced time windows throughout the day. The goal is to create conditions of fasting in the body, but not for extreme lengths of time.

Some examples of intermittent fast strategies include 10, 8, or 5 hour eating windows throughout the day, or perhaps eating just two meals each day: one in the morning, and one at night. The evolutionary premise — the argument that proponents of intermittent fasting make — is that humans evolved to optimize their health under less-than-optimal conditions. Intermittent fasting, they say, is a natural and perhaps even necessary part of being human.

The modern-day scientific correlate appears promising, too:

Most people are nowadays aware that a calorie-restricted diet has the ability not just to decrease body weight but also to lengthen a human life. Emerging research is beginning to show, however, that intermittent fasting is just as effective as calorie restriction in ensuring these health benefits! Amazingly enough, this happens without any of the psychological crippling side effects of cravings and food obsession that practictioners of calorie-restriction often experience.

Intermittent fasting women is a specific interest of mine because of what I have witnessed both in myself and in working with literally thousands of women in the PfW community.

Many women report to me (read more about that in this awesome book) that intermittent fasting causes sleeplessness, anxiety, and irregular periods, among many other symptoms hormone imbalance, such as cystic acne.

I have also personally experienced metabolic distress as a result of fasting, which is evidenced by my interest in hypocretin neurons. Hypocretin neurons have the ability to incite energetic wakefulness, and to prevent a person from falling asleep, in reaction to the body detecting a “starved” state. Hypocretin neurons are one way in which intermittent fasting may dysregulate a woman’s normal hormonal function.

After my own bad experience with IF, I decided to investigate intermittent fasting. I looked into both a) the fasting literature that paleo fasting advocates refer to, and b) the literature that exists out in the metabolic and reproductive research archives.

Intermittent Fasting Women: Problems in the Paleosphere

What I found is that the research articles cited by Mark’s Daily Apple (and others), focus on health benefits such as cancer-fighting properties, insulin sensitivity, and immune function.

However. I was struck by what seemed like an egregious sex-based oversight in that MDA post I linked to above. MDA cites this article as a “great overview” of the health benefits of intermittent fasting. This startled me because the article MDA cited was for me one of the strongest proponents of sex-specific differences in response to fasting.

Sex differences were relevant in two striking areas:

1) women in studies covered by the review did not experience increased insulin sensitivity with IF regimes and

These two phenomena mean that women’s metabolisms suffered from IF. The men’s metabolisms on the other hand improved with IF across the board. Recall that the review was reported by MDA as “a great overview of benefits [of IF].”

Secondly, in another fasting post at MDA, of which there are many, the health benefits of fasting are listed and reviewed, but the sex-specific aspects of the hormonal response go unmentioned, and reproduction/fertility/menstrual health isn’t mentioned at all.

This is not to say that Mark is not attentive to who should and who should not be fasting. He knows very well and cautions people against the dangers of fasting while stressed. Still, the mere fact of being more sensitive to fasting simply by being a woman is, I would assert, pretty important for a woman who is contemplating or already practicing IF.

This goes nearly unmentioned in the blogosphere.

Intermittent Fasting Women: Problems in the Literature

Beyond reporting biases in the blogosphere, there remains an even greater problem of a significant testing bias in the fasting literature. Searching “men” + “intermittent fasting” in a Harvard article database yields 71 peer-reviewed articles. Searching “intermittent fasting women” yields 13, none of which are a) solely about women b) controlled studies or c) about more than body weight or cardiovascular benefits.

The animal studies are more equitable, but also a bit less applicable to human studies.

It is well-known in both the research and the nutritional communities that caloric restriction is horrible for female reproductive health. This is not news. There is an infertility condition – called hypothalamic amenorrhea – that millions of women suffer from due to being overly restrictive. But what of fasting?

Intermittent Fasting Women: Should we Fast?

The few studies that exist point towards no.

It is not definitive, since the literature is so sparse, and it necessarily differs for women who are overweight versus normal weight (and who have different genetic makeups), but when it comes to hormones, women of reproductive age may do well to err on the side of caution with fasting.

What follows first is a brief review of what can be gleaned in sex-specific responses to fasting in animal studies. Afterwards I talk about what has been concluded by the few relevant human studies.

——————————————————————-

Mice & Rats

First up is a study that demonstrates the hippocampal changes of calorie restriction and intermittent fasting for both male and female rats. In this study, they do alternate day fasting, which entails free eating on one day and a fast day on the next.

The study found that brain states while fasting were different for male and female rats. For male rats the change in hippocampus size, hippocampal gene expression, and ambulatory behavior was the same no matter what kind of restricted diet they were on – but for female rats, the degree of change in brain chemistry and in behavior was directly proportional to degree of calorie intake, demonstrating the unique sensitivity of female rats to the starvation response.

” The organization of the females’ response to the energy restricted diets is suggestive of some underlying mechanism that may allow for an organized, pre-programmed, response to enhance survival in times of food scarcity. Comparatively, the males’ genetic response was less specific, suggesting that the males respond to a general stressor but they seem to lack the ability to discriminate between a high energy and low energy stressor.”

Moreover, “IF down-regulated many gene pathways in males including those involved in protein degradation and apoptosis, but up-regulated many gene pathways in females including those involved in cellular energy metabolism (glycolysis, gluconeogenesis, pentose phosphate pathway, electron transport and PGC1-α), cell cycle regulation and protein deacetylation.” In this study, both male and female rats gained small amounts of weight on IF diets.

————————————————————-

For female rats, even in the most innocuous form of restriction–intermittent fasting–significant physiological changes take place. Male rats do not experience as dramatic hippocampal and general brain chemistry change as female rats do, and their behaviors, specifically their cognition and their dirunal and nocturnal activity, do not change.

Female rats, on the other hand, “masculinize.” They stop ovulating and menstruating. They become hyper-alert, have better memories, and are more energetic during the periods in which they are supposed to be sleep. Theoretically, according to these researchers, this is an adaptive response to starvation. The more the female rats need calories– or at least the more their bodies detect a “starvation” state– the more they develop traits that will help them find food. They get smart, they get energetic, they get active, and they stop sleeping.

In a follow-up study conducted by the same researchers who explored the masculinzation of female rats, the researchers analyzed the gonadal transcription of male and female rats subjected to IF regimes.

This study found that male reproductivity up-regulates in response to metabolic stress. Female reproductivity down-regulates.

Completely opposite to the female rats becoming infertile while fasting, male rats become more fertile. In the researchers’ own words: “our data show that at the level of gonadal gene responses, the male rats on the IF regime adapt to their environment in a manner that is expected to increase the probability of eventual fertilization of females that the males predict are likely to be sub-fertile due to their perception of a food deficient environment.”

——————————————————-

In the final relevant IF rat study I could find, researchers subjected rats to the same diets– to 20 and 40 percent Calorie-Restricted (CR) diets, as well as to alternate-day fasting diets, and monitored them over the long term for hormonal responses. The results were striking. Below is the abstract in full because it’s so powerful:

Females and males typically play different roles in survival of the species and would be expected to respond differently to food scarcity or excess. To elucidate the physiological basis of sex differences in responses to energy intake, we maintained groups of male and female rats for 6 months on diets with usual, reduced [20% and 40% caloric restriction (CR), and intermittent fasting (IF)], or elevated (high-fat/high-glucose) energy levels and measured multiple physiological variables related to reproduction, energy metabolism, and behavior.

In response to 40% CR, females became emaciated, ceased cycling, underwent endocrine masculinization, exhibited a heightened stress response, increased their spontaneous activity, improved their learning and memory, and maintained elevated levels of circulating brain-derived neurotrophic factor. In contrast, males on 40% CR maintained a higher body weight than the 40% CR females and did not change their activity levels as significantly as the 40% CR females. Additionally, there was no significant change in the cognitive ability of the males on the 40% CR diet.

Males and females exhibited similar responses of circulating lipids (cholesterols/triglycerides) and energy-regulating hormones (insulin, leptin, adiponectin, ghrelin) to energy restriction, with the changes being quantitatively greater in males. The high-fat/high-glucose diet had no significant effects on most variables measured but adversely affected the reproductive cycle in females. Heightened cognition and motor activity, combined with reproductive shutdown, in females may maximize the probability of their survival during periods of energy scarcity and may be an evolutionary basis for the vulnerability of women to anorexia nervosa.

They also found this:

The weight of the adrenal gland was similar in rats on all diets; however, when normalized to body weight CR and IF diets caused a relative increase in adrenal size, the magnitude of which was greater in females, compared with males.

And this:

The testicular weight was unaffected by any of the diets. In contrast, both CR diets and the IF diet caused a decrease in the size of the ovaries.

And this, bearing in mind that “daytime” for nocturnal rats is “nighttime” for humans:

The daytime activity of females was doubled in response to IF, whereas the IF diet did not affect the activity level of males. Nighttime activity levels of males and females were unaffected by dietary energy restriction.

In males, corticosterone levels were elevated only in response to the 40% CR diet, whereas in females corticosterone levels were significantly elevated in response to all three energy-restriction diets, suggesting a relative hyperactivation in females of the adrenal stress response to reduced energy availability.

For lipids, all the rats did well: “Collectively, these data suggest that atherogenic profiles of both males and females are improved by dietary energy restriction.” Interestingly, too, as they pointed out in the abstract, human females also perform cognitively much “better” (memory and alertness) on CR and IF diets than on normal feeding schedules.

There are of course some caveats to this study: A) They are rats. B) They are somewhat “metabolically morbid” rats, which may make them more susceptible to disease. C) The rats were allowed to eat ad libitum on the IF days, but they simply did not meet their caloric requirements this way. So while it is a somewhat natural form of IF, it is still calorically reduced, such that that must be taken into account when gasping in horror at the hormonal responses of IF-ing female rats.

——————————————————–

The Few Human Studies

I mentioned above that through the same review that MDA used as a “great overview” of IF benefits for all sexes, I found harmful metabolic effects for women subjected to alternate-day fasting regimes.

This is the study:

Heilbronn et al found that with IF, insulin sensitivity improved in men (21 participants) but not in women (20 participants): after three weeks of alternate day fasting, insulin response to a test meal was reduced in men. Women experienced no significant change. “It is interesting that this effect on insulin sensitivity occurred only in male subjects,” they report.

With respect to other health markers female health actually declined, specifically with respect to glucose tolerance:

“Another diabetes risk factor that has shown a sex-specific effect is glucose tolerance. After 3 weeks of ADF, women but not men had an increase in the area under the glucose curve. This unfavorable effect on glucose tolerance in women, accompanied by an apparent lack of an effect on insulin sensitivity, suggests that short-term ADF may be more beneficial in men than in women in reducing type 2 diabetes risk. ” The opening line of their discussion reads: “Alternate day fasting may adversely affect glucose tolerance in nonobese women but not in nonobese men.”

In a follow up study, Heibron et. al studied the effects of alternate-day fasting on cardiovascular risk. When human subjects fasted on alternate days for another three week period, circulating concentrations of HDL cholesterol increased, whereas triacylglycerol concentrations decreased. This is a good thing. However, the shifts in lipid concentrations were shown to be sex specific: ie, only the women had an increase in HDL-cholesterol concentrations, and only the men had a decrease in triacylglycerol concentrations.

This study of alternate day fasting included 12 women and 4 men. In eight weeks, body weight decreased by about 10 pounds, and body fat percentage decreased from 45 to 42. Blood pressure decreased, total cholesterol, LDL cholesterol, and traicylglycerol decreased. These people were significantly obese, which limits the results of this study to an obese population. However, “perimenopausal women were excluded from the study, and postmenopausal women (absence of menses for >2 y) were required to maintain their current hormone replacement therapy regimen for the duration of the study.” (Their words, my emphasis)

The study focused on body weight composition, blood pressure, and body temperature in subjects. Subjects were fed isocalorically either one meal each day or three meals each day. All subjects were between 40 and 50 years old (excluding women of reproductive age), and between BMIs of 18 and 25. They ate, so far as I can tell, a healthy diet with 35 percent fat, PUFA < MUFA < SFA. Only 15 of the original 69 completed the study (which goes to show just how fun everyone thought fasting was). As for the results,

“Systolic and diastolic blood pressures were significantly lowered by ≈6% during the period when subjects were consuming 3 meals/d than when they were consuming 1 meal/d. No significant differences in heart rate and body temperature were observed between the 2 diet regimens. Hunger was enormously larger in the one meal/day than in the three meals/day group. “The 1 meal/d diet was significantly higher for hunger (P = 0.003), desire to eat (P = 0.004), and prospective consumption (P = 0.006) than was the 3 meals/d diet. Feelings of fullness were significantly (P = 0.001) lower in the 1 meal/d than in the 3 meals/diet.” Body weight dropped only four pounds after several months. Cortisol dropped, but Total, LDL, and HDL cholesterol were 11.7%, 16.8%, and 8.4% higher, respectively, in subjects consuming 1 meal/d than in those consuming 3 meals/d.

In sum: patients on the one meal/day regiment were unhappy, hungry, lost a little bit of weight, increased cholesterol. This was a small sample, included somewhat menopausal women, and all people of normal body weight.

Intermittent Fasting Women: In Conclusion

All that being said, that’s it. That’s all that exists! Women don’t have much to go on.

There are a few rodent studies. They found that when alternate-day fasting,female rats and found significant negative hormonal changes occurring in the females.

There are even fewer human studies. Human studies on alternate day fasting have not been conducted on women of reproductive age at all, nor have any studies analyzed reproductive responses to fasting.

Moreover, the few studies that have been conducted on non-obese women have demonstrated that their metabolic responses are not nearly as robust as those of men, and may in fact be antagonistic to their health.

This post has focused on sex-specific responses to fasting, specifically intermittent fasting women. Another important distinction to make is between different body weights. Overweight and obese patients appear to experience significant improvements with IF regimes, but normal weight patients do not show the same across-the-board benefits. For women this may be a particularly sensitive issue. Overweight women may experience metabolic benefits, whereas normal weight women do not. I suspect that that may roughly be the case, but who knows. Honestly, no one at this point.

The practical solution, then, I believe, is to look at options, to be honest about priorities, and to listen to one’s body with awareness and love.

Is fasting worth trying if a woman is overweight and trying to improve her metabolic markers, and so far hasn’t had much success? Perhaps. Should it be undertaken if a woman is of normal weight? What if she is a light sleeper? What if her periods begin to dysregulate? Or stop? What if she starts getting acne, getting a stronger appetite, or losing her appetite altogether? These things happen, and I see them in women who fast and contact me time and time again.

We women (people!) should be honest with ourselves about our priorities, and act constantly with our mental and physical health foremost in our minds. All women are different. But the literature is so sparse in this area that we cannot make any real statements or predictions about the effects of fasting, other than that we just don’t know, and that we should continue to emphasize the centrality of awareness, caution, and loving nourishment in moving forward.

——–

IF is one realm in which the female body has unique characteristics and needs that demand attention. There are boatloads of others. If you’re interested in reading about the collective set of them and learning how to optimize female skin, weight loss, and hormone balance, for a few examples, you could do worse than my best-selling book, Sexy by Nature,here.

Desiring sex, therefore, is one of the most important things we can feel.

According to a Journal of the American Medical Association (JAMA) study reported on in February 1999, about 43 percent of women (compared to 31 percent of men) suffer sexual inadequacy for one reason or another. Interestingly, this is thought to actually underestimate the real level of sexual dysfunction in the U.S. Yikes.

What follows is a description of the physiological components of female libido, how to maximize those components, and then a discussion of the psychosocial components. The psychosocial components are the trickiest to get a handle on, but they are also treatable with proper therapy (if necessary), love, empowered embodiment, and raging, well-deserved confidence.

Need more information to find you raging, well-deserved confidence? Check out my bestselling book on women’s health.

What factors play a role in female libido?

Specific foods are not in reality relevant for female libido, except for how they may temporarily increase testosterone levels (a la oysters). Instead, all of the physiological factors that influence female libido boil down to long-term sex hormone levels and balance.

First, absolute levels of hormones are important: for example, the greater amount of sex hormones in the blood, the sexier a woman will feel.

Secondly, balance is also crucial. For example, estrogen is not typically considered important in arousing a woman’s sex drive. But having clinically low estrogen levels–that is, estrogen levels below the baseline for proper sexual function–prohibits absolutely any kind of sensation a woman might have in her clitoris. That’s scary.

This is the effect that all hormones have on sex drive, generally:

1.Testosterone: Increases female libido. Testosterone is the hormone primarily responsible for sex drive in both men and women. When women with hypoactive sexual dysfunction disorder are treated with testosterone, for example, they often experienced increased sex drive.

Higher testosterone levels also enlarge the clitoris (good to know if yours is shy!), but unfortunately if other hormone levels do not rise along with testosterone, symptoms of hyperandrogenism such as facial hair and acne may manifest themselves. For this reason, testosterone supplementation is not an advisable method of increasing female libido.

2. Estrogen: Crucial at baseline for sexual function. It is also the primary hormone responsible for vaginal lubrication. However, estrogen is a testosterone antagonist, so the more estrogen a woman has in her system, the less testosterone she has available to pump up her libido. Estrogen dominance therefore is one of the greatest culprits in contemporary Western sexual dysfunction.

3. Progesterone: Another testosterone antagonist. Having elevated progesterone levels relative to the rest of the sex hormones prevents a woman from achieving orgasm.

4. Prolactin: Not talked about very often, since it’s primary role is in lactation, but it is also involved in pituitary-ovary signalling. Increasing prolactin levels increase vaginal lubrication and sex drive.

5. Luteinizing Hormone: Highly correlated with sex drive. LH is a pituitary hormone that triggers ovulation in a woman. Many researchers believe LH is one of the primary game-makers in sexual arousal.

Because of the role each of these hormones play in female libido, the menstrual cycle demonstrates a clear pattern in fluctuating libido for most women.

So how does the menstrual cycle affect female libido?

Testosterone levels rise gradually from about the 24th day of a woman’s menstrual cycle until ovulation on about the 14th day of the next cycle, and during this period women’s desire for sex has been shown, in general, to increase consistently. The 13th day (the cusp of ovulation) day is generally the day with the highest testosterone levels. It is also the day on which LH spikes. Ovulation, therefore, and no surprise here, is typically the randiest time of the month for a woman. In the week following ovulation, the testosterone level is the lowest and as a result women experience less interest in sex.

During the week following ovulation, progesterone levels increase, and this often results in a woman experiencing difficulty achieving orgasm. Although the last days of the menstrual cycle are marked by a constant testosterone level, women’s libido may boost as a result of the thickening of the uterine lining which stimulates nerve endings and makes a woman feel aroused.

Also, estrogen levels are at their lowest throughout menstruation and into the follicular phase (the first two weeks of the cycle) so women experience the least vaginal lubrication at this time. Because testosterone and estrogen are both increasing, however, sexual desire is ramping up again in time for ovulation.

What factors influence these hormone levels, and how do we make the best of them?

Estrogen Dominance: As I mentioned above, estrogen is a testosterone antagonist. When estrogen levels are too high relative to testosterone levels, female libido plummets. Women can become estrogen dominant by consuming too much soy (since soy acts as an estrogen in the body), by being overweight (since estrogen is produced in fat cells; see my book on healthy weight loss here), and by being stressed out (since estrogen can act as part of the inflammatory response). Women with estrogen dominance often experience symptoms of PMS, too, which does nothing to help libido.

Birth Control Pills: Birth control pills are another way that women can become estrogen dominant. But that is not the only way they negatively effect female libido. Progesterone levels are often elevated out of the normal range on birth control pills, and testosterone sometimes plummets.

Yet the effects of birth control pills on women is wholly unpredictable. Increasing levels of one hormone might decrease another, or might increase them exponentially, depending on how the woman’s HPA axis and ovarian feedback mechanisms work. Women also experience a whole range of side effects on birth control pills ranging from acne to suicidal depression. Birth control pills are no laughing matter, and their effect on female libido is wide ranging.

All that said, since birth control really is so unpredictable, birth control can play a stimulatory role on female libido, especially if she has chronically low levels of sex hormones in her blood. Some women feel like a million bucks on estrogen pills. If that is the case, however, birth control pills are only putting a band-aid on the problem, rather than solving it at its core. That often requires looking at physiological problems that deplete sex hormone levels such as low body fat, stress, and energy deficits.

Testosterone blockers: Some women get on testosterone blockers to help them with symptoms of hyperandrogenism or problems in their menstrual cycles that come from high testosterone production. However, blocking testosterone is as good as eliminating it entirely. Spironolactone and flutamide are the two most commonly used testosterone blockers.

Hypothyroidism: Up to ten percent of women have clinical or sublicinical low thyroid issues. Hypothyroidism is significantly linked to low libido. T3, the active form of thyroid hormone, is crucial for the proper functioning of cells and organs. Without T3, the reproductive system barely manages to inch forward. Sex hormones suffer greatly, both at the ovarian level as well as in production at the hypothalamic and pituitary levels.

Hypothyroidism is caused by a wide variety of problems. Hashimoto’s thyroiditis is a an autoimmune condition that accounts for the vast majority of Western hypothyroidism. This can be mitigated by eliminating modern toxins, specifically wheat, dairy, and omega 6 vegetable oils, from the diet, and also by paying attention to gut health with gut-healing diets such as the GAPS diet or the one I recommend in Sexy By Nature.

Iodine-deficient diets can cause hypothyroidism. This used to be uncommon in western countries, since western countries iodize their salt, but sea salt often does not contain much iodine in it. Moreover, many Americans are now eschewing salt for “health benefits” (this is misguided), so their iodine levels are suffering. The solution to this is to consume iodized salt, or to perhaps supplement with kelp for a while. Iodine supplementation is tricky, however, and should build up slowly a la the recommendations of Paul Jaminet.

High intake of raw cruciferous vegetables can hurt an already suffering thyroid gland. Yet more importantly, low-carbohydrate diets contribute to hypothyroidism. Glucose is required for the conversion of T4 to T3 in the liver, so without adequate glucose supplies the body’s thyroid functioning suffers. This is a problem that many paleo women wrestle with. Adding just 50 or 100 grams of starchy carbohydrate to a daily diet, however, can increase energy, improve sleep quality, improve quality of skin and hair, and also boost reproductive function.

Repairing sub-clinical hypothyroidism has also been shown to remove ovarian cysts and help anovulatory women both ovulate and menstruate. For more on hypothyroidism, see Chris Kresser‘s work.

Stress: Stress is a psychological libido-killer, but it also has a physiological analog. When stressed, the body produces cortisol. Cortisol has a negative feedback effect on the hypothalamus, and it can inhibit all of the hormonal signalling that comes out of the hypothalamus. The hypothalamus is responsible for inciting pituitary function, so stress plays a very real role in inhibiting reproductive function. As many as five percent of women suffer reproductive symptoms of chronic stress.

Low Dopamine: Dopamine is the most important neurotransmitter for sexual prowess and reproductive function. Fortunately, dopamine deficiencies are very often corrected with the introduction of exercise into someone’s daily life. Almost nothing increases dopamine levels as well as exercise does. (Although sex also has potent dopamine-releasing effects: skin-to-skin contact shoots dopamine levels through the roof. But then dopamine levels plummet post-orgasm, creating withdrawal-type symptoms. This is how the body reinforces sexual behavior.)

Some women have reported to me personally the return of menstruation from amenorrhea after resuming regular sexual activity. They were as surprised as I was. Yet perhaps we should not have been so surprised. Dopamine is a potent neurotransmitter and, coupled with serotonin, can significantly up-regulate sex hormone production.

Low serotonin: Though excess serotonin has been linked to decreased arousal, serotonin also increases prolactin levels. Prolactin is important for vaginal lubrication and for sexual arousal. Ways to increase serotonin levels include adequate protein ingestion (.5 g/lb of lean body weight each day), adequate sun exposure, and perhaps most important of all, adequate sleep.

Low Body Fat/Excess Exercise/Energy Deficits: These three phenomenon almost always manifest in tandem. Yet the end result is the same: with low body fat, with excess exercise, and with caloric deficits, the body detects starvation. Leptin levels plummet, and the hypothalamus stops thinking that the body is sufficiently fed. Without leptin, the entire pituitary sex hormone cascade is not enacted. No LH, no testosterone, no estrogen, no prolactin, no progesterone. Body fat is unquestionably crucial for all reproductive function. Female libido just happens to be the one that’s the most fun to explore once proper body fat levels are restored.

————————————————————-

Psychological factors effecting female libido:

There remain the psychological aspects to increasing female libido. And of them there are many. Perhaps a woman’s libido has been killed by a negative sexual experience. Or perhaps the woman is too stressed out by other factors to care about sex…or perhaps sexual relations between two people are strained because they can’t stand each other outside of the bedroom even more than they can’t stand each other inside the bedroom. Perhaps a woman’s lover is an ugly lump.

Many of those factors are outside my realm of expertise.

Some of them are inside of it, however, and fiercely.

Women need first to think they are sexy. I am so tired of women comparing themselves to others, and always thinking that beauty is relative. Beauty is not relative. It is everywhere. And in everyone. If she is beautiful it does not mean that you are less so. Period. I don’t care if you have a chubby stomach. I don’t care if you think your hair is boring. I don’t care if your right boob is larger than your left. Not a single other person cares either. At all. The only person who cares is you. No one wants to make you “perfect” but you.

You don’t have a single thing in the world to apologize for. No one is looking for apologies.

Instead, people are looking for statements. They are looking for fun. They are looking for inspiration, for character, and for life.

In that way, what other people want from each other is not necessarily for them to meet some ridiculous standard but instead to make them feel good. Whether that’s through sharing of your self-love, through your wicked personality, or through your liberated and unapologetically wild fantasies is totally up to you. The point being that confidence and self-love are the most important factors for actually being attractive. Sure, classic “looks” may follow, but only after a woman has convinced others that she is worth looking at.

Not a single person in the world wants to sleep with an apologizer. “Sorry, I don’t like who I am,” does not necessarily read like a 5-star resume. People won’t be throwing themselves at that. What they will instead throw themselves at is: “I am different from what you expect. But that’s an asset. I am worthy like you wouldn’t believe, and I am going to rock your world.”

Confidence is key. Beauty is key. And the thing is– damnit–it’s not faked confidence. It’s not faked beauty. You really are beautiful. You really are unique. You really are a natural, sexual, alive, vibrant woman. You do not have a thing in the world to apologize for. You are who you are, and you love being yourself, and you can share yourself powerfully and joyfully with others through sex.

This kind of self-love is why people get laid. It’s not because they have perfect torsos and racks as big as wombats. It’s because they have hot souls.

So confidence is important. So important, I wrote a book on how to find it through food and lifestyle. There’s one other crucial aspect I can speak to. It’s this:

SEX IS AWESOME.

IT IS NOT DIRTY.

Look. Sex is natural. Sex is so natural, in fact, that it’s the very reason we all exist. And sexual desire is natural. It is, by extension, the very reason we all exist. For that reason, along with many others, there is not a single immoral aspect to having sexual desire or having sex. Period.

And sex is not gross.

And a woman’s desire is not gross.

And a woman’s vagina is not gross.

And a woman having sex is not gross and not a slut.

Or maybe she is a slut, but that’s cool because that’s natural, too.

Men who don’t understand any of that are not real men.

The whole point being that American culture is a culture in which sexuality, and female sexuality in particular, is a dirty thing.

That is not okay.

It’s so not okay.

It is, in fact, plain old wrong. Sex is natural. If a woman (or man!) wants to be delighting in it, and more power to her. She is embracing her natural body. She is embracing her natural desires. She is owning her own confidence. And she is exalting in the vibrancy of her very existence.

Vitamin D is one of the most important vitamins, and one we are most likely to be deficient in as Americans. Some estimates say anywhere from 80-90% of the population may have sub optimal levels of Vitamin D in the blood.

This is worrying because Vitamin D plays such an important role in health. From reducing autoimmune issues and inflammation, to preventing disease, Vitamin D is a nutrient we shouldn’t neglect.

Here are 3 important reasons to make sure you’re getting enough, and even supplement if you are at risk for deficiency.

#1 Immune System

The major reason to supplement with Vitamin D is its importance in the immune system- with everything from upper respiratory infections to cancer.

Vitamin D has a protective effect on the immune system, helping T-cells and B-cells to to fight immune threats while also preventing autoimmune issues.

Several autoimmune diseases (including Lupus and MS) have a high range of deficiency and supplementation with Vitamin D has been shown to improve health in these individuals.

Having sufficient Vitamin has been shown to reduce upper respiratory infections in both summer and winter. Those with deficiencies of Vitamin D are found to suffer from upper respiratory infections much more often, even accounting for the seasons.

Fun fact: before they knew about Vitamin D, tuberculosis patients were sent to sanitariums. They were prescribed lots of sunlight which they believed cured the tuberculosis.

People have also taken cod liver oil for ages for its health benefits. Cod liver oil is a great source of Vitamin D.

Vitamin D also reduces inflammation in the body, making it important for people with many health conditions like diabetes, infertility, autoimmunity, or metabolic syndrome.

#2 Bone Health

It’s a well accepted fact in the medical community that Vitamin D is just as important for bone health as calcium because of the role it plays as a calcium cofactor.

Vitamin D helps maintain calcium homeostasis in the body. That’s why so many calcium supplements now also have Vitamin D.

Vitamin D promotes mineralization of the collagen matrix in bone.

Both women and men commonly don’t get enough calcium or Vitamin D through the diet and may need to consider supplementation.

Another important Vitamin for bone health, and still relatively unknown, is Vitamin K2. Many supplements don’t contain all three and may not be as effective.

#3 Happiness

The last and best reason to supplement with Vitamin D is that it promotes happiness and emotional stability.

It is very common for people to feel sad, depressed, or anxious during the winter and to feel happier in summer.

Likewise, those who work outside or have ample sunshine time during the day report happier moods than those stuck in dark offices all day.

There’s something to this besides the fun of swimming and eating ice cream.

Vitamin D, the sunshine vitamin, is primarily processed through the skin rather than through food. During the summer, we wear less and tend to spend more time outdoors, and this increases the amount we produce. In turn, we get sick less often and feel altogether happier.

Since Vitamin D is a fat soluble vitamin, it’s important not to take too much, since the body does store some.

However, Vitamin D needs range depending on specific conditions. Recommendations for average adults age 19-50 are about 600 i/u a day to prevent deficiency. This can come from sunlight, diet, or supplements, but it may take up to 1500 or 2000 i/u a day, depending on the individual, to keep blood levels about the recommended 30 ng/ml.

Obese individuals, those with active infections, or those taking certain medications may need twice as much Vitamin D. Excess fat actually shuffles Vitamin D into the fat so that the body cannot use all of it.

Many in the natural health community recommend even higher levels. They probably have a point since with the use of sunscreen, we may not be getting enough Vitamin D even during summer and food provides relatively little.

A Vitamin D blood test is relatively inexpensive and easy to order. I’d recommend asking your doctor to run it the next time you have blood run so you can see where you’re at.

Also recommended is to get at least 30 minutes of direct sunlight to a majority of skin per day.

If that’s not possible, I recommend taking a supplement like this one which contains Vitamin D, A, and K, all necessary cofactors. Find it here.

Be careful if you also take other supplements or a multivitamin as these often contain Vitamin D as well and make sure you aren’t taking too much.

When looking for a vitamin D supplement, look for Vitamin D3, the form that is best absorbed by the body.

I’ve been working with women who have PCOS now for more than 5 years. In this time, I’ve encountered hundreds if not thousands of specific cases. Iv’e read just about every blog, website, and article there is out there for PCOS. I’ve spent hours searching through online forums and facebook communities, learning about women’s experiences.

After all this time, I’ve learned a thing or two (or several hundred) about what’s right for PCOS, as well as what isn’t.

To help prevent you from making the same mistakes I see over and over again with women who have PCOS, I’ve put together a list of the 10 most common ones. Hopefully then you’ll be able to dodge the bullet, so to speak, and overcome PCOS quickly and painlessly.

Going on the Birth Control Pill

The birth control pill might be a good way to mask symptoms of PCOS, but it never fixes the underlying problem. In fact, many women who go on the pill find that their PCOS has worsens while on it, but don’t find out until they get off the pill, try to get pregnant, then can’t. Birth Control Pills are one of the most favored “solutions” for PCOS of doctors, but they are completely ineffective in terms of healing, fertility, or long-term freedom from PCOS.

Using Metformin

Due to its ability to increase insulin sensitivity, Metformin is one of the most commonly prescribed medications in the Western world. Metformin can help alleviate complications from diabetes, as well as help women who have PCOS, especially type 1 PCOS (more on which in video #2). Metformin is a problem, however, since much like birth control pills, in that it never solves the underlying problem causing hormone imbalance and PCOS. It only ever covers it up.

Taking estrogen blockers

Thousands of women take Estro block or other estrogen blockers in hopes of helping their PCOS. However, estrogen is generally not the main problem for women with PCOS. If you’re taking estrogen blockers, you may be targeting the wrong hormones. Instead, consider looking into ways to decrease testosterone and/or DHEA-S levels, especially if you are “type 1 PCOS”. If you are “type 2 PCOS,” more estrogen might actually be what you need.

Taking herbal supplements

Admittedly, some women find great relief from herbal supplements. But just like with Metformin and birth control pills, they don’t provide permanent solutions. They only help to alleviate symptoms and cover up underlying issues. Also, they are not well studied by the scientific literature, so their effects are not well known. Most supposed “effects” of herbal supplements simply come from people’s stories. So it may be worthwhile to experiment with herbal supplements while addressing underlying issues, but this should be done carefully, and with due acknowledgement of the fact that it may not fix underlying issues.

Doing a lot of cardio

Is more always better? For exercise, the answer is no, especially if you’re spending all your time on a bike or a treadmill. The best way to exercise for PCOS is to shoot for efficiency: short, intense, effective exercises instead of long, grueling, stamina-demanding exercises are best. This is because short and intense work outs (such as lifting heavy weights) help improve insulin levels and hormone balance, while long-distances exercises can help, but not quite as much. Most women do well shooting for 3-4 weight lifting work outs a week.

Failing to investigate underlying causes

Trying to overcome PCOS without paying attention to its underlying causes is like shooting in the dark. Getting your hormone levels tested by a doctor, by a functional medicine practitioner, or with a home saliva test is a great way to get data on what’s going on in your body. If you don’t have access to that, learning about the potential causes and types of PCOS and their symptoms (which I’ll discuss some in video #2) may very well be enough. The more you know about what’s causing your PCOS, the more specifically you can treat it.

Low carb diets

Most women who have PCOS try a low carbohydrate diet. Is this effective? Sometimes. But not all women are helped by it. In fact, more than 20% of women who have PCOS may be hurt by it. If you try a low carb diet, pay close attention to your symptoms and see if they get better or worse. That way, you can stop yourself from doing damage if you are one of the 20% of women who really need those carbs.

Low fat, high protein diets

Common nutritional wisdom says that low fat, high protein diets are best. Nutritionists or magazines might tell you to eat salad with low fat dressing and lean chicken breast. But this is not necessarily best, and definitely not for women with hormone imbalance. Hormones (and other important parts of the body, such as brain matter) are made out of fat. Without it, as you heal from PCOS, your body won’t be able to produce the hormones it needs. Fat is a friend, for all women with PCOS.

Dining out

Unfortunately, dining out in the West is full of potential dangers for women with PCOS. One of the worst dangers is the fact that the vast majority of restaurants use vegetable oil for their cooking. Vegetable oil (including corn oil, soybean oil, sunflower oil, rapeseed oil, canola oil, and more) is rich in omega 6 fatty acids, which cause inflammation. Inflammation is one of the most common underlying issues that women with PCOS suffer from. To help minimize your inflammation levels, consider dining out as little as possible, or specifically requesting olive oil or butter to be used for your meals. Additionally, adding a fermented cod liver oil supplement (fermentation prevents the fats from oxidizing and keeps them healthful) is one quick way to start reducing inflammation levels.

Ignoring potential red flags

Irregular or absent periods, acne, facial hair growth, and difficulty losing weight are all potential symptoms of PCOS. But it’s important when you’re looking for the underlying causes of PCOS to pay attention to other symptoms you experience. Do you have good digestive health? Are you chronically cold? Do you suffer from chronic headaches? Any symptom you experience in your body could help point to underlying causes.

If you’re looking for help on your journey with PCOS – and want to do things like pay attention to red flags, and avoid all the mistakes these women have, I can help you. There are countless posts on my blog about various things concerning PCOS. You can catch a list of the most popular ones at the page labeled PCOS.

You can also, if you’re ready to get serious about healing (did I tell you I overcame PCOS in 6 weeks once I finally figured out what my underlying problem was?), check out my totally risk free program for overcoming PCOS: PCOS Unlocked: The Manual.

If you have PCOS, you’ve probably tried a number of things to help your health, and you probably have a number of concerns.

Women with PCOS are more likely to be overweight or obese, more likely to suffer metabolic disorders and insulin-related conditions, and, alongside the extra facial hair, irregular periods, and infertility, it’s a lot to take.

But the more prevalent PCOS becomes, the more research is done, and new things are coming out all the time!

I’m so excited to bring you this information on L-carnitine, a very special amino acid that can help women with PCOS lose weight naturally and feel more energetic.

L-carnitine is a nootropic amino acid found typically in meat products and milk.

Nootropics are types of supplements (like adaptogens) that work with the brain to increase it’s efficiency.

L-carnitine helps alleviate the effects of aging and disease on mitochondria, while increasing the mitochondria’s potential to burn fat.

For most people (i.e. those without PCOS) it is not a nutrient of concern and they synthesize an ample amount internally and from lysine and methionine in foods. However, it has been found that women with PCOS are often deficient in L-carnitine, regardless of their diets.

L-carnitine improves insulin sensitivity and helps lower blood glucose, which is valuable for women with PCOS who are usually insulin resistant.

This ability, plus the fact that PCOS women are often deficient in L-carnitine seem to make l-carnitine effective in promoting natural weight loss.

It is also known to increase energy, lower ammonia, enhance energy during cancer treatment, improve exercise tolerance and energy in those with conditions like angina and congestive heart failure, and enhance sperm morphology, in case you were curious!

Although studies regarding weight loss with l-carnitine in general seem to find mixed benefit, studies which look at those deficient in l-carnitine or those with insulin resistance and metabolic syndrome find it does help.

In fact, a recent study of PCOS only women found that compared to placebo, statistically significant weight loss occurred over 12 weeks with supplementation.

This is excellent news since it is no secret that PCOS women, with their hormone imbalances and insulin resistance typically struggle to maintain a healthy weight.

Adverse effects are rare but can include gastrointestinal disturbance, body odor, and seizures. I’ve heard from some women that it causes a “fishy” odor in the urine, which can be unpleasant. It may possibly interact with anticoagulants and certain thyroid medications so, like with any supplement or diet, you should get the okay from your doctor.

Typical doses in the studies that showed weight loss benefits ranged from 500-2,000 mg a day, with 2,000 mg. a day being what was used with PCOS women.

Though the evidence for this supplement in PCOS are somewhat new, there’s enough promise that I find it interesting for PCOS ladies looking for weight loss help. It’s not a magic pill, and a focus on healthy dietary habits is absolutely still vital for women the PCOS.

But, one of the cool things about L-carnitine is that it is best deposited into muscles in hyperinsulinemic states, or during times when insulin is high (which is almost all the time for most PCOS women).

That means those with insulin resistant conditions would see the most benefit from supplementation.

If you’re interested in trying L-carnintine, give it at least 12 weeks of supplementation. This is one (find l-carnitine on amazon here) I particularly like because the pills are in 1000 mg amounts so you can just take 2 a day, with meals.

Yet emerging science is beginning to demonstrate that probiotics could play a role. In fact, probiotics could be a key component to an estrogen dominance solution.

Here’s how:

Estrogen dominance: Probiotics for reducing Beta-glucuronidase

I know it’s a mouthful, but it’s important.

Beta-glucuronidase is an enzyme that is produced by “bad bacteria.” This enzyme breaks the bond between an important molecule the liver creates – glucuronic acid – and a toxin to which glucuronic acid is attached. The liver excretes glucuronic acid specifically in order to attach to toxins and then excrete them out of the body.

When beta-glucuronidase breaks the bond between glucuronic acid and toxins in the gut, these toxins are then freed to be reabsorbed back into the bloodstream through the intestinal walls.

This is extremely problematic.

All sorts of bad molecules count as “toxins.” This ranges from heavy metals to toxic by-products of your body’s metabolism, to excess estrogen.

The liver is the body’s primary way of clearing “old” hormones out of the body. If you don’t have an efficient disposal system – that is, if your liver doesn’t function properly or if estrogen gets reabsorbed back into your body – then your hormone levels will simply keep piling up over time.

OR a high quality probiotic supplement such as my personal favorite Prescript Assist, will help boost good gut flora in your intestines, and replace the bad.

This will reduce the rate at which glucuronic acid is separated from toxins, and therefore help you excrete all the toxins your liver processes. Including estrogen.

Estrogen dominance: probiotics for increasing gut motility

Another powerful effect probiotics can have on estrogen dominance is by speeding up the rate of your bowels.

An unfortunately high percentage of women are constipated. An even higher percentage aren’t necessarily constipated per se, but do not have regular bowels movements – at least once a day.

This is okay, it’s not necessarily a bad thing for your health. But it does mean that you may be reabsorbing more toxins into your bloodstream than you would like.

The slower your digestion is, the more time toxins have to hang out in your intestines and get reabsorbed.

The speedier your digestion is (or, at least, having a health rate of digestion), the more efficiently your body will be able to empty out excess estrogen and other molecules your body doesn’t want hanging around.

The reason probiotics can help with this is that gut flora actually comprise a whopping 30% of the bulk of your stool. The more bulk you have – and of the healthy sort – the better your stool will move along. Gut flora also help process the foodstuff in your gut, which makes that more digestible and easily excretable as well.

Estrogen dominance: probiotics for reducing inflammation

Probiotics are now well known to help reduce inflammation in the body in a number of ways.

This has a number of positive downstream effects. One of them is on hormone production.

When the body is inflamed, it doesn’t necessarily produce hormones in the correct amounts. In fact, the body will often over-produce estrogen in times of stress, as it is a part of the pro-inflammatory response. This is important to note: reducing inflammation can help reduce excess estrogen levels, and reducing excess estrogen levels can help reduce inflammation. Estrogen is complex.

But it is clear that excess inflammation is harmful, and that estrogen can play a role in it.

So marshalling all your resources – including a healthy gut biome – in fighting inflammation can go a long way towards hormone health.